NPI | 1346620069 |
---|---|
Former Name | AMANDA J COPPINGER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9116134) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA058558) |
363A00000X Physician Assistant | |
Enumeration Date | 2015-06-08 |
Last Update Date | 2023-03-09 |